Doctor Name: | MS. ANNE MARIE VERONICA BANTLE |
NPI Number: | 1083044481 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 338224 |
Business Practice Address: | 600 Harlem Rd West Seneca, NY - 142241151 |
Business Phone Number: | 7163322121 |
Business Fax Number: | 7163322122 |
Mailing Address: | 600 Harlem Rd, WEST SENECA |
State: | NY |
Postal Code: | 142241151 |
Phone Number: | 7163322121 |
Fax Number: | 7163322122 |
NPI Enumeration Date: | 11/21/2013 |
NPI Last Update Date: | 06/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 338224 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |